Incidence of major drug interactions and associated adverse drug events in a surgical intensive care unit
Purpose: To estimate the incidence of major drug interactions (MDI) and associated adverse drug events (ADE) in a surgical intensive care unit (SICU). Methods: Patients admitted to the SICU at The University of Texas MD Anderson Cancer Center (MDA) for ≥ 96 hours from July 1, 1993 through June 30, 1994 were identified from the MDA Patient Care Information System. Medication use records were extracted from the MDA Division of Pharmacy database and matched with each patient record in a database program. Query reports were designed to identify potential major drug-drug interactions. A MDI was defined as those interactions which are well-documented and which have the potential of being harmful to the patient. Upon identification of a MDI, the patient medical record was reviewed for evidence of associated ADE. Results: 275 patients were admitted to the SICU, some of which were admitted several times for a total of 290 SICU stays. The mean length of stay in the SICU was 16 (range 4-151) days. These patients received a mean of 29 (range 12-55) different drugs per stay. 33 MDI were identified in 29 patients (see table). The 1 year incidence was 11.4%. No associated ADE were identified: Precipitating Object Drug Drug # Neuromuscular blockers Aminoglycerides 19 Beta-blockers Epinephrine 3 Insulin Chlorpromazine 1 Spironolactone Potassium 4 Digoxin Quinidine 4 Phenytoin Rifampin 2 Conclusions: MDI are common in our patient population. However, no patient experienced an associated ADE. Clinical Implications: Polypharmacy in the ICU is common and drug interactions with the potential for adverse events frequent.
Oeser, D., Polansky, M., Thomas-Parks, P., & Varon, J. (1996). Incidence of major drug interactions and associated adverse drug events in a surgical intensive care unit. Chest, 110 (4 SUPPL.). Retrieved from https://hsrc.himmelfarb.gwu.edu/smhs_pa_facpubs/105